Multiple Mental Illnesses With A Mood Disorder

I’d like to thank my Facebook followers for the suggestions for blog posts on content they would like to see. Doug provided a great idea to discuss multiple diagnoses in the form of Bipolar Disorder and Borderline Personality Disorder. I did some research on the subject, including the article he provided, and I have decided it would be a disservice for me to attempt to speak about that experience. A very large part of what I do here, on Facebook, and on my website is based through experience. However, Doug’s suggestion did jog an idea in my mind that I haven’t put forward yet in regards to multiple diagnoses. It is at this point that I would like to remind you that this is only a theory, but one I’ve formulated through observation over the past 17 years or so.

Multiple mental illness in a person is not uncommon. Some mental illnesses have components of others in them; such as people with PTSD with a Depression component. That creates an even more unique situation when they get combined in a single person. Bipolar Disorder affects each person with it in ways that are personal to them and their mentality. Medical professionals attempt to treat based off of loose interpretations of the symptoms. A depressed person may not be suicidal while another is. They both meet the criteria for depression, just differently.

The combination of multiple mental illnesses in a person will create something that is almost entirely unique to them. Thus, it will be harder to find a treatment that will work properly for the person due to that interaction.

That brings me to my theory: I wonder if people with multiple diagnoses may benefit from focusing on getting any mood disorder under control first. Not because it is any more important than the others, but the way a mood disorder like Bipolar Disorder or depression affects your baseline thinking. It alters your perception of the world around you, in turn, your mind reacts to what it perceives as opposed to what actually is.

As an example; I did not find out about high-functioning autism until my son was diagnosed with it. Going back and reading about it to understand it was like reading a biography. I feel that I am a very high functional autistic because I lack many of the interpersonal functions that are typical for a normal mind. There is also the autistic focuses, the inability to convert emotion to words, logical to a fault, inability to read people naturally, and several other things. It takes a lot of energy for me to function in a social way because I have to think about all the things that other people do subconsciously. As I looked back on my life, I began to see certain patterns and interactions in the ways that Bipolar Disorder and the HFA meshed for me.

The one great fear I have in my life is completely losing touch with reality in a Bipolar unwell period. If my mind ventures too far out- there is only hate, rage, loathing, and despair. There is no love, there is no kindness, no understanding, no vestiges of positivity at all. At that point I become Mr. Hyde to my normal Dr. Jeckyll. Due to the HFA, I have a hard time connecting and empathizing with people in a natural way. I feel that if I really rocketed out of control, the combination of all that negativity with my inability to empathize with others would probably result in a newscast ending with “… and police killed the suspect in the ensuing shootout.”

Let’s cut back to the mood disorder for just a moment. It affects how you interpret things:

– I drop a glass of water and break it.
*Manic: Fuck that goddamn glass! No dustpan? I’ll just clean it up with my hands.
*Depressed: I can’t believe I dropped a glass of water. Can’t even do that right.

The reality of the situation is – a glass of water was dropped. That’s it. A mood disorder skews the situation into extremes. It stains all of the information that comes into your mind before your mind has a chance to really interpret it. The tainted information is already being fed into a mentally ill mind that will skew it even further out of perspective. Sort of like putting a second bullhorn in front of a first bullhorn.

Assume that our example person is Bipolar and Schizophrenic. They are driving along and notice in their rear view mirror that the same car has been behind them for three different turns. The information is processed and skewed as potentially threatening by Bipolar Disorder then sent into the conscious mind where Schizophrenic thought processes could continue to stretch it and spin it out of control.

But what if that person had a good medication regiment for the Bipolar side of their struggle? A mood stabilizer would prevent the Bipolar side of their mind from pulling the situation too far out of proportion before it gets fed into the active mind where Schizophrenia will now contribute to playing with it.

I think this thought process may be applicable for a lot of people. If a person’s perception is at least somewhat healthy, then the circumstances going on around them won’t enter their active mind in an already spun state. The schizophrenia will still have an impact; but which would be better for it to spin? “There’s a car behind me that’s been there for a while. That’s odd. I don’t like that.” or “That son of a bitch is fucking following me. I know it.”

I’m inclined to think the second one is more likely to escalate out of control.

Thus, it seems to me that getting the gateway, perception altering Disorder under control will make all the other things in the person’s mind more manageable. That is not to suggest that everything else should be ignored. It just may be a more effective starting point for the person with two, four, or more mental illnesses with a mood disorder.

I’m curious to hear other peoples’ thoughts on this idea. Feel free to comment!

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36 Responses to Multiple Mental Illnesses With A Mood Disorder

I am the one you talked about in the first description. Bipolar II with PTSD and depression. That is almost exactly the way I would react except I would not think about picking it up with my hands but would feel overwhelmed and not be able to pick it up at all. Without my medications I am completely overwhelmed by even the most simple task. Even with my meds I get overwhelmed pretty easily. This was good reading!!

Thanks for commenting Nancy. Getting overwhelmed and shutting down is a pretty common response as well. I know that when I’m escalated, little issues like personal safety and well-being are an afterthought for me.

The idea of treating one illness first is interesting. I wonder how a psychiatrist would respond to this. I’m unsure if they have a complete understanding of which disorder reacts in the mind first. I suppose that would take some serious study that would require participants to really record what is going on in their minds, and that would be a lot to ask of them. I try to record what is going on in my head sometimes and it is really an exhausting task. As far as I know I only have one disorder – bipolar, so I can’t really contribute to the discussion on that plane. I have experienced mental illness with chemical dependency, however, and those two diagnoses MUST be addressed together. You can’t treat one and not the other because they make each other worse. I would think having bipolar and schizophrenia would be similar. I work in adult foster care and I have a client whose schizophrenia is worse during bipolar episodes. I think he hears more voices when hes manic, etc. I would think you would have to be treating both with medications but then maybe focusing primarily on the bipolar in therapy, like you said, as to not overwhelm the person. It seems to me like a lot of psychiatry is a guessing game. It really is too bad mental illness isn’t understood better. I’m hoping it will be in my lifetime.

Hey Sophie. Thanks for commenting. I agree with you that chemical dependency is a definite need for addressing at any point because not only is it a coping mechanism but it makes the problem worse. (I used to drink, do coke, pot, and about whatever pills I could get my hands on; so I’m not entirely unfamiliar with those struggles.)

My thinking on the matter is; when you have so many complicated issues going on at the same time. Maybe it would be helpful to break the approach down rather than say.. attempting to medicate four different mental illnesses at the same time with all the happy fun times that goes along with medication mixing and how it affects each other.

Another thought that was in my mind was reaching extremes. The point when I was diagnosed there was only two paths available; either something had to change or I was going to kill myself. I couldn’t deal with it anymore. At that, I was willing to try anything. So part of my hope for the reader is that if they have been going through the years with no real progress, maybe it’ll jog a different way to look their situation.

There are some interactions that I’m not sure on either. Like.. I’m not sure if you could really address the depression without addressing the PTSD in cases when they are tied together. Maybe someone in the field will be able to shed some light on it if there is someone among the readers.

You have such a wonderful way of expressing what it is like to live with multiple mental illnesses. I think what you are doing is heroic and encouraging. Thank you so much for this amazing post. I am now a new follower and a fan!
I have been diagnosed as bipolar, OCD, ADHD, Anxiety disorder, and PTSD. I have recently come to the conclusion that medication alone cannot cure these illnesses. I have worked hard to shed the labels that society has placed on me and through positive affirmations, writing, dancing, yoga and meditation I have been able to cope with the above labels. I recently started a blog called without a label to help give some much needed inspiration, acceptance, hope, peace, understanding, compassion, joy, and strength to myself and anyone else that suffers from similar illnesses like mine. I would love to share posts with you and place you as a guest author on my site , that is if you would like to. Please feel free to email me at kimberly_mcpherson@hotmail.com and put something in the subject area along the lines of guest blogging or bipolar and I will set you up just as soon as I hear from you. I look forward to possibly working with you to spread the awareness of these illnesses and put a stop to the stigma that is attached to them. I absolutely love what you are doing and I hope you continue to kick some major @$$!
Much love and abundant blessings,
Kimmyhttp://www.withoutalabel.mehttps://www.facebook.com/www.withoutalabel.me
P.S. If there is anything else I can do to spread the word of your site please feel free to let me know and I will do it!

This is very curious to me as right now as I’m searching for an explanation for my son’s diagnosis. He’s 20 and has “collected” many diagnosis including: tourette syndrome, adhd, ocd, conduct disorder, social phobia, seperation anxiety, verbal L.D., bipolar I- rapid and mixed, and pddnos. Oh, and generalized anxiety disorder. It seems to me that one diagnosis would “umbrella” these disorders. He is going to a neuropsycholoigist for an assesment for social security benefits if he qualifies for it. My therapist suspects aspergers and referred me to their DD person. How can one person have so many diagnosis?? He has gotten into trouble with drinking alcohol which makes him go into a rage. This lead to dual diagnosis counseling mandated by the court. I really feel he is aspergers although, as you said, he has many aspects but not all of it. I would welcome your thoughts…

Hello Sasha. What you are describing is a pretty common problem. A medical professional only sees a person for a very limited amount of time; nothing like what you or other people close to him spend with him. Based on your information and their limited observation, they will diagnosis him with whatever seems mostly similar. The problem is that different doctors have different interpretations. Different symptoms can be interpreted differently. And all in all; it’s a very inexact science because mental illness is so personal. Once they arrive at a diagnosis, they throw a medication or treatment at the patient to see if it sticks. Sounds shitty? It is. But brain chemistry is as unique to each of us as our fingerprints. That’s really the only way to find a medication that works.

The drinking and flying into a rage thing, to my knowledge, isn’t associated with mental illness directly. But one needs to consider that alcohol affects the base chemistry of the brain. So the chemistry change could easily throw his moods around.

For now, keep pushing on the Disability angle. Once he has SS benefits he will be able to get treatment much easier with Medicare.

I would also start researching family history in-depth if you have not. Mental illness is typically genetic. You may be able to ascertain clues about what he may have inherited (taking into consideration any serious traumas that might have caused trauma-oriented mental illness to manifest).

Unfortunately, the only answer in a lot of cases is patience and working one’s way through it.

I recently wrote an in-depth article on EZine Articles that relates to your situation with the mental health profession. Here’s a link for you.

Thank you for responding to my questions. Zach has had alot of various dr.’s and now has one that has been seeing him since he was 16. With him, things have sort of “evolved”. What I mean is: she didn’t want to diagnose him as bipolar until it had a pattern. The anger and rigid thinking has been true of him forever. His quirks and fears have also been forever. Do you or anyone else you’ve heard of have all these diagnosis’s that turned out to fall under one mental illnes or disorder? My gut feeling is he is aspergers. He has only drank a handful of times but he cannot handle alcohol at all. He’s on lithium and lamictal as well as a new med called fluphenazine for tourettes. I guess I’m looking for a reason or answer to all this and more than anything: hope. Thank you for listening.

Quite a few of the things you mentioned could overlap. For example- the OCD could be part of High-Functioning Autism (HFA) (Asperger’s falls into that spectrum). As you seem to know, HFA’s need a high degree of structure and order in their lives. Disruptions can cause extreme discomfort which can easily manifest as rage. ADHD, Social Anxiety, OCD, and Separation Anxiety could all be part of being a HFA/PPD-NOS.

General Anxiety Disorders can be associated with just about any mental illness as well. It’s very common to see an Anxiety disorder with about any mental illness.

I have crossed paths with people that have had a laundry list of diagnoses like this. The people that did have that many breaks in their mind usually had a reason in their history for it. Severe trauma, child abuse, sexual abuse, severe drug/alcohol abuse while pregnant; that sort of thing. There are quite a few that are misdiagnosed.

Disorders like Bipolar, Tourettes, and Autism are all typically genetic. In my case- I’m a high-functioning autistic and Type 2 Bipolar. Once my mother found her biological mother and I started inquiring around- I found that there was a very clear history of both in the family.

I suspect that since your son has had so many doctors, they all saw different mental afflictions and diagnosed them as illnesses instead of symptoms. It is a very common thing.

I think he’s on the right path sticking with the doctor he’s been seeing for the last four years. Familiarity will allow that doctor to get a clearer picture of what is going on in his mind.

Always maintain your hope for Zach. A correct diagnosis and proper management allows many with severe mental illness to function in a fairly typical way. Unfortunately, we usually end up passing through a hurricane grade shitstorm to get to that point. Just keep pushing forward, focus on one day at a time.

You may also be interested in visiting http://www.dbsalliance.org which is a Non-Profit group founded and run by people with mood disorders that have recovered and help others get well. Their forum community is very good. They also have a subforum aimed towards parents and people that love those with mental illness. You may be able to find support for yourself with other parents that have gone or are going through similar circumstances.

Hi Dennis, I can tell you that wthout a doubt Zach hasn’t had any childhood trauma. He has always been a high needs child. He didn’t do any drugs or alcohol until he was 17, so the run of it hasn’t been too long lived either. Zach did however have alot of chaos growing up as his brother and sister were quite difficult as teens. They are both bipolar. I also have ptsd and adhd, and I’m bipolar II. My husband is adhd also, so Zach got the genectic guns pointed right at him! His brother and sister are 9 and 11 years older so I do think it affected him to have all the drama going on back then. Interesting to note for anyone who blogs here; if your child is what they term “high needs” or difficult, there is something probably going on. I knew, but no Dr. would listen to me; which was maddening! He is very depressed right now and we’re trying to encourage him to call his doc, which he has a hard time doing. So, thanks for letting me talk on-Sasha

My son is Asperger’s spectrum. His diagnosis is how I ended up learning about it and realizing it was the final missing piece in my own life. So genetics does play a huge role, which I’m sure you well know.

Instead of encouraging him to call his doctor, inform him an hour or two ahead of time that you are going to call at a specific time and hand the phone off to him. The forewarning will give him time to get his mind acclimated to what is going to occur, so as to not disrupt his sense of order too much. Then you can place the call and hand the phone off.

In dealing with a Major Depression component of Bipolar Disorder most of my life, I’ve come to realize that the initial hurdle is always the worst, always the hardest, always the perfect time to say “Oh I’ll do it later/tomorrow/any time frame to shut the other person up”.

Anyway, you’re welcome for being a sounding board. It’s part of why I run this site.

And to add to your comment, for anyone reading, a doctor that will not listen to you is useless for wellness. Find another. But be certain you go in with more than “My child isn’t right”. A doctor cannot act on that alone. Record any odd behavior, particularly that would impede the child waging a “typical” life.

The conscious mind is the part of your mind that is most active when you’re awake. It’s the part of your mind that is doing the active thinking and decision making while you are awake and aware. The subconscious mind governs things like your dreams, mannerisms, body functions, and anything else about you that really doesn’t require conscious thought. Like- you don’t have to think about breathing, you just do it. That’s your subconscious mind at work.

The way Bipolar Disorder affects them both, at it’s most basic, is that it simply changes the way the person perceives things- not always in a good way. An unwell person could be sitting alone and all of the sudden they are struck with a crippling fear that they are being watched (subconscious mind) so they decide to grab a knife and hide in their closet (conscious mind).

My mom was diagnosed with some sort of mental illness in 2005. I was never allowed to go with her, but even that being said, I know for a fact that my mother has at least 3 mental illness.

Bipolar
Schizophrenia
Narcissism

She was treated for a very short period of time with risperadal and seroquil. But they made her pretty much stop caring about life, she stopped bathing etc. And that was just not my mom. She had OCD and herself and her house had to be clean. After taking those drugs she was never the same, so she stopped taking them.

They only gave her ativan a short period of time, which seemed to help the most. But they refused to give it to her as it was “habit forming”

Since then she has been self medicating with alcohol and is now dying with end stage liver failure from the alcohol abuse. I cannot get her primary care dr’s or her hospice people to understand she has a mental illness, as she has tried hiding it for years. They think I am the crazy one.

I am lost and cannot get any help from anyone in her hometown. She has accused me of stealing from her, and has tried to get me into trouble with the law.

That sounds like a rough situation you find yourself in. I have some questions and possibly some insight for you on your situation.

What makes you think that her doctors and healthcare workers think you’re the crazy one? If she has been treated for mental illness before, it’s in her medical records. They would know just by looking at them.

Now, in all likelihood, you’re probably not going to be able to get anyone to help your mother in a way that I think you’re looking for. The medical establishment cannot force her to do anything or hospitalize her unless she is a significant threat to herself or another. So unless she asks for help or wants help; there isn’t really a whole lot more you can do. They can’t force her to take meds or try to get stable. She has to want it. And for her to want it, she has to realize there is a major problem. If she’s a narcissist; she’s probably just going to make it out to be everyone else’s fault.

It is unfortunate but you may have to take whatever means is necessary to protect your own stability and well-being. You can’t really rule anything out with the severely mentally ill. If you’re able to, enjoy whatever time you possibly can with her while she’s still here. But if she won’t listen to reason or even realizes there is a problem in the first place; there really isn’t anything you can do past that.

You’re a good daughter for doing everything you have to try and help your mother- but everyone has their limits. Don’t feel bad if she’s pushed you to yours.

For what it’s worth- I’m sorry for your pain and the difficult circumstances you find yourself in with her.

Thank you for this article and your last comment, I left a very one sided relationship with a bipolar man who accused me of stealing and whose episodes kept getting worse, I pray for him often but we couldn’t. Communicate well and lost interested in us ultimately choosing pill therapy. It was encouraging to read that others know it’s more than the meds, it’s also your circle as if you’re surrounded by enablers you can’t grow into a,better stable state. For caregivers and loved ones this issue of limits is a tough one, how do u reach the in some cases unreachable mind. He didn’t even care that we’re expecting but . Look forward to this new life despite it all.

Your post is pretty much spot on, Caramel. Attempting to reach an unreachable mind is the multi-billion dollar question- in that you’d probably be making that if you could figure out the answer! A lot of times the person in question has to really crash and hit such a low that they can see no other way to go but to change their life. From what I’ve seen; that usually means losing close to everything unfortunately.

Life moving forward will undoubtedly be challenging but rewarding. There’s always the possibility that he will rebalance too. Unwell thought processes can run over everything if the person isn’t adept at fighting them. So it’s not surprising that the baby didn’t have any affect either.

The future is often chaotic for we Bipolars. He could rebalance, he may not. All you can really do is what you need to do for yourself and the baby now. Worry about taking care of the two you first right now.

Dennis, I appreciate your insight. You are right I have decided to focus on my new family and heal. Its not a bad as its been in the past, in a way the previous episodes have made this time easier to move on. Also, I am now responsible for a life and that must be my focus. I appreciate forums like this, for some they are life saving, for some they are day saving- same thing really 🙂

I really enjoyed this article I suffer from bi polar, PTSD, borderline personality disorder, and I have not been diagnosed with schizophrenia but I think I have it to. I have started to notice extreme paranoia in the last 6 months to a year. I get on meds then stop, u have such a amazing way of explaing what a person is feeling. I hate that I have no control over my emotions thoughts or even my reactions, I hate what it does to my family, because for the last 10 years I have struggled with addiction, I am now at a point where I can no longer handle the fact that I have no control over my own self. I am a cutter but had stopped for a year, but recently started again and it is scaring me BC I cut depper than I ever have. I am going to a treatment facility for my drug addiction and would like to get on my meds again but they never can seem to get them right so I always give up…. Lost

Hello, Shay. You may also want to have a look at/talk to your doctor about schizoaffective disorder. It’s essentially a combination of schizophrenia and bipolar disorder that is fairly misdiagnosed. So if you’re diagnosed Bipolar and are having schizophrenic problems; it may be worth talking to your doctor about if only to eliminate it as a possibility.

Thank you for the compliment on my expression! A big part of my goal with my website is to help people understand, in real terms, what people like you and I deal with.

It’s unfortunate hearing about your back-slide; but you’re still hear to keep pressing forward and fighting. Try not to let yourself get discouraged if the meds aren’t working for you. It can take awhile to find the right ones. I’ve been trying to find an antidepressant that works for me for about 4 years now. It sucks fucking ass but it is what it is. I’ll find one eventually because I’ll keep looking.

Just to keep things in perspective; remember that even though our brains have similar functionality, your brain chemistry is as unique to you as your fingerprints. Thus it can be really hard to find something that really works for you. But when you do, hopefully those destructive impulses will recede and you can enjoy life a bit better.

Good luck at the facility and make the most of it while you’re in. Even though you feel lost; you’re on the right path!

Hi..I have been depressed feeling for as long as I can remember. During my pregnancy it got worse and I put on antidepressants then. After I gave birth, it was WAY worse. I pretty much had a mild nervous breakdown after returning to work and had to go to the ER. I never returned to work, and began seeing a psychiatrist. I was diagnosed with generalized anxiety disorder and bipolar disorder (I am assuming it is type II). I have been seeing the same psychiatrist since then, and that has been about 10 1/2 yrs. I have been on and off of pretty much ALL the different antidepressants, and have never found any sort of normalcy. Currently I take Prozac, Lithium, Latuda, and Xanax. I believe there may be other problems going on here. Like ADHD and OCD, but I haven’t been diagnosed as that. What can I do? Do I talk to my Dr. about this or will he think I am trying to get other meds? I feel crazy. I go from emotion to emotion in a matter of minutes, have gained SO much weight from the Prozac, SO much fluid and hair loss from the Lithium, and pretty much just feel crappy. Anyone have ANY suggestions? Help, please.

About the only suggestion I can offer is to consult with a different doctor. There are people that are heavily resistant to the various medications though. So you may be in that camp of people. Either way; it may be beneficial to get some new eyes on the situation since you’ve been with this doctor for such a long time and haven’t made much progress. You’ll want to discuss why you feel like your diagnosis may be wrong by presenting fact-oriented points. If you haven’t already, research what you’ve been diagnosed with heavily to see how well it jives with what you experienced so you can articulate the differences and problems you experience to another doctor. You may also want to do some reading on mania and hypomania to see if you actually do experience the upper end of being Bipolar.

Never put too much trust into a healthcare provider. They are people. They make mistakes too. If it’s been ten and a half years and you’re still not more balanced or better; you should definitely at least talk to someone else about your situation.

Hi I’ve laterly decided to have a proper look into mental disorders, multiple personality disorders etc because ever since watching a documentary about schizo and then my geography teacher suggesting i seem to have a few of the diognosis for it something clicked and i started looking back on my life from before i can remember (what ive been told) and I’m not sure if i fit into any catergories.. Is it possible for things like seeing/hearing/believing things to be mixed with mood/personality change? I struggle to put what i want to say into words so i hope this makes some sort of sense but please reply to my e-mail adress joshvash@live.com

Overlap can occur in a lot of ways with mental illness. The best thing you can do is get in and talk to a professional as soon as possible. Chances are pretty good that you won’t figure it out on your own. Convincing yourself you have mental illness A when, in fact, you have mental illness B can significantly set back your wellness. Speculation can be very harmful. If you suspect you have a mental illness; make a list of the strange behaviors that have a significant negative impact on your life. These are the things the doctors will want to start with and work backwards from.

For example; in my case, one time I had a bout of extreme rage while on antidepressants because the milk was holding the door of the refrigerator open. I almost destroyed the refrigerator because of it. These kinds of extremes or strange circumstances are what you want to document.

Honestly the most up front explanation I have ever read I suffer from bipolar1 personality disorder and I have schizophrenic tendencies iv been having relationship issues due to my illness iv been struggling with since I was about 5 years old iv been hospitalized multiple times iv overdosed multiple times and I have created a monster it seems like to me but my hope in controlling my issue and slowing it down for me to get ahead has been a constant struggle and what you said helped in some kind of way and I can tell you got a problem to but who doesn’t I appreciate being able to relate and you not being a crock of shit like Tessa yelton keep doing what you do you can help the whole the world if you put your mind to it

Thank you for reading my work and taking the time to comment, Jacob. I know the grind to try and get ahead is so fucking difficult. I feel for your struggle in trying to get ahead. Keep pushing though. I won’t offer you bullshit about “it’ll get better” blah blah blah; what I will say is, so long as you continue to try and fight you have the opportunity to actually pull ahead. Keep pushing.

I try to make it a point to not “whine” about my path in life or the challenges I’ve personally faced. I know people like yourself have had a much harder path than I. And really, just reinforcing that we’re not as alone as we typically feel is a big part of what I want to accomplish here.

Hello,
I found this article very interesting. I’m going on four years of dealing with SAD, anxiety, and depression. I only just started getting help a year ago. We started treatment to help combat the SAD, I went through many medications that all caused more harm than good. I was put on a new medicine about last May and by the time it had taken affect, I was thrown into a deep depressive state that I had my sister take me to the hospital because I didn’t think I’d make it through the night. Turns out the medicine I was on was one of the worst for people who have Bipolar. I spoke with a psychiatrist at the hospital and he told me he believed I had bipolar and needed to be off the medicine immediately. I went off the meds and stayed off them for two months. Finally, the school year came back around and I knew I needed to be on something before leaving home and going a few hours away. My doctor put me on a mood stabilizer that has helped a lot with minimal side effects, I usually get every single one. I’ve been on it for 3 months, and although I think I need a higher dose, I am finally beginning to think I’ll be okay. But alas, the trend of the past three years is holding up. I have depression, and it effects me almost every day, but when I get to this time of year, I get SAD in the worst way. Each year it comes on sooner and harder than ever. I know I need to be back on depression meds asap and get in with a psych to help with all this. Without my girlfriend I know I wouldn’t be alive today so I’m very thankful for our friendship and what she has done for me that she’ll never know. It’s just so hard to have 4 disorders, 3 year round. Any two of them are effecting me almost every day of my life. I hope one day I’ll figure out what it’s like to live without crippling mental disorders.
Thank you for the article. I truly believe the treatment of a mood disorder before anything else is the best way to go. I also react the same way with the example of bipolar vs depression.

Thank you for taking the time to comment. I’m happy to hear you’re making progress in dealing with all of this!

One thing I might point out, you may want to ask your doctor if a Vitamin D supplement will help minimize your SAD. One of the big contributors of SAD is a lack of sunshine. Sunshine gives your body additional Vitamin D which is also tied to mood regulation. It won’t “cure” your depression or anything to that extreme, but it could help lessen the effects of SAD. Ask your doctor if it would be an alright choice for you before you decide to take any.

I’m saddled with PTSD, Autism and Bipolar Disorder. Those issues, in combination with the fact I’m gay, an immigrant and a mixed-race person, makes me as complicated as fuck. As expected, I dealt with all these issues by drinking and drugging a lot – 22 years of crack cocaine which stopped 2 years ago, and drinking regularly since I’ve been 18. I’m 54 now. The last time I drank was about 10 hours ago. No one here would have to guess I’ve been suicidal all my life; that would be a given. My combination of issues has resulted in me having an enormously lonely life. How I’m still alive today is a mystery.

I wandered onto this site today because I was researching how psychiatrists and psychologists treat people with multiple mental illnesses. Stabilize the mood first. That sounds good. I wonder, though – can you effectively treat someone with multiple mental illnesses? What I mean by that is, “Well, he’s the manual for schizophrenia, so let’s use those teachings and that medication.” Along with, “Well, here’s the manual for Autism, so let’s use those teachings and that medication.” Can these approaches really work when one disorder interacts with another? Maybe schizophrenia mixed with Autism, or bipolar mixed with PTSD mixed with Autism, presents a conundrum so unique that no manual or medication could even come close to “fixing” these perfect storms.

And that’s my main issue. There are so many “discrepancies” with me that I feel bad for the mental health individuals who attempt to heal me. To me, they all fail because there is no manual which says, “Here is how you treat someone with the Perfect Storm of Autism, PTSD and Bipolar,” or “Here is how you treat someone with schizophrenia, chronic depression and PTSD.” And even if those books did exist, can you imagine one that says, “Here is how you treat a gay, mixed-race immigrant with PTSD, Autism, and Bipolar disorder”?. Actually, I think there is a book for that. It’s called, “You’re fucked. Get used to it.”

Hello, RR. Thanks for taking the time to comment. I want to point out that I purposefully edited out your name and website URL because you’re talking about some personal stuff here, and you don’t want it showing up later if someone decides to Google your name. In the future, be mindful not to use personally identifiable information in a public space when talking about these things, unless that’s what you’re actively choosing to do.

Let my start by saying, congratulations on your two years without crack! That’s a pretty solid achievement.

The second thing I’d like to comment is that I am not a mental health professional of any sort. I wrote this article, and tried to demonstrate through that writing, that it was just a theory and wondering out loud. I do not know if there is any clinical merit to the ideas I expressed therein and it should not be taken that way at all.

The third is, I don’t know, your life, or what you’ve been through. The rest of my reply should be filtered through the idea of general knowledge, not necessarily your situation specifically. I’m not judging you or anything you’ve done to survive what you deal with. I know I’ve done plenty of shit I wasn’t necessarily proud of to survive.

So, generally speaking, the way mental illness gets treated is by looking at the symptoms that are negatively impacting the person’s ability to conduct their life. I’ll use Bipolar Disorder as an example. Bipolar Disorder is typically treated with a mood stabilizer to control mania, at minimum. There are people with Bipolar Disorder who are very high functioning, they stay on the top end of the Disorder most often and may only experience a periodic crash into depression. Thus, it may not be necessary for that person to be on an antidepressant to control depression if they are only depressed a few weeks out of the years. On the other hand, you have people like myself who are depressed a majority of the time and only hypomanic from time to time. I absolutely need an antidepressant to bring up the bottom end; but I also need a mood stabilizer so the antidepressant doesn’t force me into mania. Treating mental illness is a very individual process. It’s not like, “Oh you have a headache, here take some aspirin.” and it’ll work for most people.

The professional will attempt to identify the symptoms that are most problematic to the person and work to bring in those extremes into a functional space.

Here are some important problems with that.

1. A lot of patients don’t understand their mental illnesses well enough to help their professionals figure out what’s actually going on. Some people simply don’t understand, others are too ill to actually see how mentally ill they are, and far more. Point being, it’s incredibly difficult for a mental health professional to help drive to a reasonable solution off of an hour or so of interaction every few weeks. You state a belief in your post that I encourage people to discard: Mental health professionals, therapy, and medication do not “fix” us. They enable us to better control our mental illness ourselves, to fix ourselves. At least, that’s supposed to be the idea.

2. Everything you put in your body affects the way your mental illness functions. Mental illness is very much affected by your body and brain chemistry. Both of those are drastically affected by literally everything you put in your body from diet to drugs. The alcohol and drugs can drastically change the way that medication is supposed to function inside of you. Without them? Who knows what may or may not have worked for you in that time. Those additional chemicals in your body very likely contributed to making your long-term instability worse while providing the short-term “benefit” that many of us turn to substance abuse for. Again, no judgment. I’ve abused several drugs and alcohol in my life; including crack when I was younger. Drugs helped me survive some very dark times. Unfortunately, drugs and alcohol are poisonous for long-term stability and recovery. That’s a big reason why you’re not supposed to drink or do drugs with psych meds.

Then you have the other issue of lack of real compliance and patience. Again, I don’t know you so I don’t know what your path has been. But one thing I regularly see is that folks do not give the medications appropriate time to actually work. A lot of them are started off on an introductory dose to start getting your body used to the presence, and then it is stepped up over the course of months to therapeutic levels where it can provide real benefit. A lot of us never reach that point because we want the short-term benefits of what alcohol and illegal drugs provide. That’s just not how it works.

To tie it all together into plain English; being a long-term drug and alcohol user has most definitely made your journey harder. It may very well be the reason you haven’t found real, lasting recovery. Bipolar Disorder and PTSD are generally fairly treatable; but the whole thing is drastically more complicated with addiction/alcoholism. You have to look at addiction/alcoholism as another piece of that larger puzzle that’s preventing your recovery. Now, if you think you may want to do something about the alcohol as well, definitely talk to your doctor about it all first.

Alcohol itself is a depressant. Throw that into the mix with Bipolar Disorder and PTSD and it is just making the mountain you need to climb taller.

This was a good read. I can speak first hand on treating one illness first. After my first psychotic episode and hospitalization at 25 I was diagnosed with BP 1-mixed episodes with psychotic features, PTSD, Boarderline Personality Disorder, Anxiety, and depression and ADHD. Along with anxiety the DRs treated the Bipolar, anxiety, and ADHD. Once I finally got balanced out I was having severe loneliness and depression apparently from BPD which had never before surfaced. I found it very hard to take once my mind became so quiet. I have since greatly reduced my bipolar meds and the noise in my head returned some-but I don’t feel so terribly lonely. I don’t even know how treatable BPD is but the Bipolar always kept the BPD symptoms in the background until now. If one is treated first, other diagnosis may emerge more clearly. That’s my theory. I do wish I could meet more people like me.

Hello. Thanks for taking the time to share your story. I’ve known a couple other people that this sort of thing has happened to as well, though not as cleanly as you’re describing. A close friend of mine had a similar issue when she started finding success on meds. She couldn’t deal with the silence in her mind after decades of it being unquiet.

I don’t know if you have any in your area, but you may want to check into local support groups to see if you can find some more people to be around. If you have anxiety issues, most will let you just observe until you feel comfortable enough to participate.

BPD is treatable as well. You would want to discuss options to work on that with your professionals for your treatment plan though. It is something worth exploring.